Prolonged Light Menstrual Flow: Causes and Concerns - Obstetrics and Gynecology

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Understanding prolonged light menstrual flow can be complex, especially when considering underlying conditions such as polycystic ovary syndrome (PCOS). Your experience of having a prolonged light menstrual flow, particularly with the presence of brown discharge, can be concerning, and it is understandable that you have questions regarding this situation.

Firstly, it is important to note that brown discharge often indicates older blood that has taken longer to exit the uterus. This can occur at the beginning or end of a menstrual cycle. In your case, the prolonged duration of this brown discharge, followed by light red bleeding, suggests that your menstrual cycle may be irregular, which is common in individuals with PCOS. PCOS can lead to hormonal imbalances that affect the regularity and flow of menstrual cycles, resulting in lighter or prolonged bleeding episodes.

The medications prescribed to you, such as Tranexamic Acid (often referred to as "斷血炎") and Metformin (安胰敏), are typically used to manage heavy menstrual bleeding and improve insulin sensitivity, respectively. Tranexamic Acid works by helping to reduce bleeding, and it is often effective in shortening the duration of menstrual flow. While it is difficult to predict with certainty whether your bleeding will stop after four days of taking Tranexamic Acid, many patients do experience a reduction in bleeding after starting this medication.

Regarding your concern about whether stopping Metformin after the bleeding stops will lead to a recurrence of bleeding, it is essential to understand that Metformin is primarily used to manage insulin levels and can help regulate menstrual cycles over time. If your bleeding stops while on Tranexamic Acid, it is advisable to consult your healthcare provider before making any changes to your medication regimen. They can provide guidance based on your specific health needs and the underlying causes of your menstrual irregularities.

Stress can also play a significant role in menstrual irregularities. High levels of stress can affect hormonal balance, potentially leading to changes in your menstrual cycle. If you have been experiencing increased stress, it could contribute to the irregularities you are observing.

If you are considering engaging in sexual activity after your bleeding has stopped, it is generally safe to do so, but it is crucial to monitor your body’s response. If you experience any unusual bleeding or discomfort, it is advisable to consult your healthcare provider promptly.

In summary, your prolonged light menstrual flow is likely related to your history of PCOS and possibly exacerbated by stress. The medications prescribed should help manage your symptoms, but it is essential to maintain open communication with your healthcare provider regarding any changes in your condition. Regular follow-ups and monitoring are key to managing PCOS effectively and ensuring your reproductive health remains stable. If you have further concerns or if your symptoms persist, do not hesitate to seek additional medical advice.